Negative one-year outcomes of Mitra-FR led to several discussions and hypothesis, especially after the COAPT was published only a few weeks later. According to the COAPT study, the MitraClip was able to reduce hospitalization rate for cardiac failure and also all-cause mortality, compared against optimal medical treatment alone. When comparing the COAPT to the Mitra-FR,...
ESC 2019 | COMPLETE: Definitive Evidence for Infarction with Multivessel Disease
For patients with ST-segment elevation acute myocardial infarction and multivessel disease beyond the culprit artery, complete revascularization is superior to culprit-only treatment as regards the final endpoint, a composite of cardiovascular death, infarction, and ischemia-driven revascularization over a mean follow-up of 3 years. This information derives from long-awaited randomized study COMPLETE, finally presented at the...
ESC 2019 | POPULAR AGE: Good Old Clopidogrel Still Valid
According to this study, presented during the ESC 2019 scientific sessions, non-ST acute coronary syndrome (NSTE-ACS) patients treated with ticagrelor presented a significantly higher risk of bleeding than patients treated with clopidogrel, with no counterbalance by higher benefit in thrombotic events. Researchers suggest clopidogrel might be the gold standard for this elderly NSTE-ACS population, though...
Vena Cava Filter for All Patients After Severe Trauma
Until today, there was no evidence warranting the early implantation of a vena cava filter for the reduction of the risk of pulmonary embolism in patients with severe trauma and contraindication to prophylactic anticoagulation. This article, soon to be published in the New England Medical Journal (NEJM), brings us such evidence and we surrender to...
Clinical Implications of the New Hypertension Guidelines
Hypertension is the first modifiable risk factor affecting morbidity and mortality in nearly half of the adults in the US. The new ACC/AHA guidelines have issued new standards for the detection assessment and management of high blood pressure. The major change compared against their prior version was stage 1 hypertension definition, defined as systolic blood...
II International Symposium on Innovations in the Treatment of Coronary Artery Disease and Structural Heart Disease
The II International Symposium on Innovations in the Treatment of Coronary Artery Disease and Structural Heart Disease will take place on July 31st, 2019 at the Syrian-Lebanese Hospital in São Paulo. This event seeks to provide a better understanding of indications and clinical and interventional strategies for complex heart conditions, such as left main coronary...
MitraClip in the “Real World”
Courtesy of Dr. Carlos Fava. Mitral regurgitation (MR) is the most frequent valvulopathy in Europe and US, affecting close to 10% of patients over 75, with more morbidity and mortality. The treatment of choice is percutaneous repair instead of replacement, to maintain the sub-valvular apparatus that contributes to systole. This is feasible and has better...
Surprising EXCEL Outcomes in Diabetics with Main Left Stenosis
This study especially designed to compare PCI vs. CABG in patients with left main coronary artery disease and low to intermediate Syntax score showed that 30-day and 3 -year outcomes of PCI with everolimus eluting stents vs CABG were consistent both in diabetic and non-diabetic patients. The randomized EXCEL trial (Evaluation of XIENCE versus Coronary...
Good Outcomes for MitraClip “Off Label”
Courtesy of Dr. Carlos Fava. Mitral regurgitation is the most frequent type of valve disease, accounting for >6% of patients over 65 years old. Surgery is currently the strategy of choice, but percutaneous treatment is a valid alternative. The long-term progress of symptomatic patients at high surgical risk who do not meet the formal indications for...
The Most Important Articles of 2018 in Structural Heart Diseases
1- ESC 2018 | MITRA FR: Testing MitraClip for Secondary Mitral Regurgitation In secondary mitral regurgitation, mitral-valve leaflets and chordae are structurally normal and mitral regurgitation results from alterations in left ventricular geometry and function. Read more 2- TCT 2018 | COAPT: MitraClip in Patients with Secondary Mitral Regurgitation The prognosis of patients with...